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Nurse-Family Partnership (NFP)® Meets HHS Criteria

Last updated: October 2019

In Brief

Evidence of Model Effectiveness

This model meets the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model” for the general population, but does not meet the criteria for tribal populations.

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Model Description

The Nurse-Family Partnership (NFP) is designed for first-time, low-income mothers and their children. It includes one-on-one home visits by a trained registered professional nurse to participating clients. The visits begin early in the woman’s pregnancy (with program enrollment no later than the 28th week of gestation) and conclude when the woman’s child turns 2 years old. NFP is designed to improve (1) prenatal and maternal health and birth outcomes, (2) child health and development, and (3) families’ economic self-sufficiency and/or maternal life course development. For more information, please read the Model Overview.

This report also includes a review of an alternate implementation of NFP, which had paraprofessionals, rather than nurses, conduct the home visits. The paraprofessionals received the same length of training as the nurses and carried the same caseloads, but had a higher supervisor-to-home visitor ratio.

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Extent of Evidence

Nurse-Family Partnership (NFP)®
Results of Research and Review
Number of studies
Eligible for review
47
Rated high
22
Rated moderate
6
Rated low
16
Additional source1
3
NFP with Paraprofessional Home Visitors - Mothers with low psychological resources subgroup
Results of Research and Review
Number of studies
Eligible for review
2
Rated high
2
Rated moderate
0
Rated low
0
Additional source1
0
NFP with Paraprofessional Home Visitors
Results of Research and Review
Number of studies
Eligible for review
4
Rated high
3
Rated moderate
0
Rated low
1
Additional source1
0
NFP with Nurse Home Visitors - Mothers with low psychological resources subgroup
Results of Research and Review
Number of studies
Eligible for review
6
Rated high
5
Rated moderate
1
Rated low
0
Additional source1
0

1Additional sources overlap with another study and are not rated.

For more information, see the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.

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Summary of Findings

Outcome domain links to effects details by study.
Nurse-Family Partnership (NFP)®
Outcomes
Primary Outcome Measures
Secondary Outcome Measures

Outcome Child Development and School Readiness

Primary outcome measures:
Favorable: 7
No effect: 67
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 1
No effect: 17
Unfavorable or ambiguous: 1

Outcome Child Health

Primary outcome measures:
Favorable: 6
No effect: 27
Unfavorable or ambiguous: 1
Secondary outcome measures:
Favorable: 5
No effect: 45
Unfavorable or ambiguous: 1

Outcome Family Economic Self-Sufficiency

Primary outcome measures:
Favorable: 4
No effect: 16
Unfavorable or ambiguous: 1
Secondary outcome measures:
Favorable: 17
No effect: 78
Unfavorable or ambiguous: 1

Outcome Linkages and Referrals

Primary outcome measures:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 1

Outcome Maternal Health

Primary outcome measures:
Favorable: 8
No effect: 18
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 18
No effect: 70
Unfavorable or ambiguous: 0

Outcome Positive Parenting Practices

Primary outcome measures:
Favorable: 5
No effect: 18
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 2
No effect: 11
Unfavorable or ambiguous: 0

Outcome Reductions In Child Maltreatment

Primary outcome measures:
Favorable: 7
No effect: 18
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Primary outcome measures:
Favorable: 0
No effect: 5
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 9
No effect: 62
Unfavorable or ambiguous: 1
NFP with Paraprofessional Home Visitors - Mothers with low psychological resources subgroup
Outcomes
Primary Outcome Measures
Secondary Outcome Measures

Outcome Child Development and School Readiness

Primary outcome measures:
Favorable: 3
No effect: 30
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 1
No effect: 3
Unfavorable or ambiguous: 0

Outcome Child Health

Not measured in high- or moderate-rated outcomes

Outcome Family Economic Self-Sufficiency

Not measured in high- or moderate-rated outcomes

Outcome Linkages and Referrals

Not measured in high- or moderate-rated outcomes

Outcome Maternal Health

Not measured in high- or moderate-rated outcomes

Outcome Positive Parenting Practices

Not measured in high- or moderate-rated outcomes

Outcome Reductions in Child Maltreatment

Not measured in high- or moderate-rated outcomes

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Not measured in high- or moderate-rated outcomes
NFP with Paraprofessional Home Visitors
Outcomes
Primary Outcome Measures
Secondary Outcome Measures

Outcome Child Development and School Readiness

Primary outcome measures:
Favorable: 0
No effect: 30
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 0
No effect: 4
Unfavorable or ambiguous: 0

Outcome Child Health

Primary outcome measures:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 1
No effect: 1
Unfavorable or ambiguous: 0

Outcome Family Economic Self-Sufficiency

Primary outcome measures:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 2
No effect: 11
Unfavorable or ambiguous: 1

Outcome Linkages and Referrals

Not measured in high- or moderate-rated outcomes

Outcome Maternal Health

Primary outcome measures:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 3
No effect: 11
Unfavorable or ambiguous: 0

Outcome Positive Parenting Practices

Primary outcome measures:
Favorable: 1
No effect: 3
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Outcome Reductions in Child Maltreatment

Not measured in high- or moderate-rated outcomes

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Primary outcome measures:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 0
No effect: 2
Unfavorable or ambiguous: 0
NFP with Nurse Home Visitors - Mothers with low psychological resources subgroup
Outcomes
Primary Outcome Measures
Secondary Outcome Measures

Outcome Child Development and School Readiness

Primary outcome measures:
Favorable: 22
No effect: 34
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 0
No effect: 7
Unfavorable or ambiguous: 0

Outcome Child Health

Not measured in high- or moderate-rated outcomes

Outcome Family Economic Self-Sufficiency

Primary outcome measures:
Favorable: 0
No effect: 6
Unfavorable or ambiguous: 1
Secondary outcome measures:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Outcome Linkages and Referrals

Not measured in high- or moderate-rated outcomes

Outcome Maternal Health

Not measured in high- or moderate-rated outcomes

Outcome Positive Parenting Practices

Not measured in high- or moderate-rated outcomes

Outcome Reductions in Child Maltreatment

Not measured in high- or moderate-rated outcomes

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Primary outcome measures:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 0
No effect: 3
Unfavorable or ambiguous: 0

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.

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Criteria Established by the Department of Health and Human Services

Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
Nurse-Family Partnership (NFP)®
High- or moderate-quality impact study?
Yes
Across high- or moderate-quality studies, favorable impacts in at least two outcome domains within one sample OR the same domain for at least two non-overlapping samples?
Yes
Favorable impacts on full sample?
Yes
Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?1
Yes
One or more favorable, statistically significant impact reported in a peer-reviewed journal?1
Yes
NFP with Paraprofessional Home Visitors
High- or moderate-quality impact study?
Yes
Across high- or moderate-quality studies, favorable impacts in at least two outcome domains within one sample OR the same domain for at least two non-overlapping samples?
Yes
Favorable impacts on full sample?
Yes
Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?1
Yes
One or more favorable, statistically significant impact reported in a peer-reviewed journal?1
Yes

1This information is reported for all models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

Please read the HHS Criteria for Evidence-Based Models for more information.

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